20130266 Permit Pkg 07302013 � j
�aF tHEa� City of Yelm Permit No.: 20130266
� Community Development Department Issue Date: 7/30/2013
d tu (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
L
W�RM�NGtON Fax: (360)458-3144
Applicant:
Name: STACY CRAIN Phone:
Address: 8270 28TH CT NE
LACEY WA 98516
Property Information:
Site Address: 1201 YELM AVE E 100B Owner: STACY CRAIN
Assessor Parcel No.: 22730110403 Subdivision: Lot:
Contractor Information:
Name: STACY CRAIN Phone:
Address:
8270 28TH CT NE
LACEY WA 98516
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: COMMERCIAL REMODEL
Description of Work: LIMEBERRY TI, B OCCUPANCY WITH 15 OR LESS
Sq. Ft per floor: First Heat Type(Electric,Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
BUILDING BAILEY GENERAL CONTRACTOR $ 576.26
TOTAL FEES: S 576.26
i
� Applicant's Affidavit: OFFICIAL USE ONLY
� I certify that I have read and examined the infortnation contained within the application and know the same
to be true and correct.I also certify that the proposed structure is in conformity with all applicable City of #Sets of Prints:
Yelm regulations including those governing zoning and land subdivision,and in addition,all covenants,
easements and restrictions of record. If applying as a contractor,I further certify that I am currently Final Inspection:
registered in the State of Washington.
��,�"%-.�--- � _.� �}�- (�' Date:
� Signature Date
� BY�
' Firm
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Cit� of Yel�
(36 ) 458-8402
REC#: 00134406 7/30/2U13 3:12 PM
OPER; CO TERM: OU1
REF#: 1029
TRAN: 33.0000 BUILD57� 26CRTT5
, 20130266
CRAIN, 5TACY
1201 YELM AVE 5�6126CR
BLDG
TENDERED: 576,26 CHECK
APPLIED: 576.26-
CHANGE: � ���
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CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
� ���"�1�°t�! ��'. �,,�'�'A, �� '��:r Parcel#: ' ��' `���f �,°`� `�
Project Address: � `
Zonin ���""^''����L Current Use: ���?� f� �' ' Proposed Use: � -+�i�-� t r° '
9;
/Re-Roof�Tenan�t Improvement�
�P umpogstructioMechanical Re-Mode�l Fire Prevent/�upp�ess�Alarm Other
❑
,
_
Project Description/Scope of Work: �i��7%4'L-L �c r;,�.- ", . � (`%1�G'�htCd�C. r�c.. •Vt-.!,' 1 �i?c>�'�r .,
yp�oac P'�-�.
Project Value:��DU� �"� �,��
Building Area(sq. ft) Parking Garage 1St Floor ��GZ2"d Floor 3`d Floor
Building Height �
Are there any environmentally sensitive areas located on the parcel? �C� If yes, a
completed environmental checklist must accompany permit application.
�$UILDING 0�1f�1��ENl��V��M � � � - " AwT
ADDRESS %J C� G 4Kt` p EMAIL r�rs� d..:��^C. "C � z" �'e.,,.,.,,
CITY � �' STATE n�` ZIP '- TELEPHONE � '"'4�t �!4��';�Y .
� ARCHITECT/ENGINEER /�✓E= i��- LICENSE# /�
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
� GENFRAL CONTRACTOF� TELEPHONE � �y '��+
j �
ADDRESS v � - EMAIL��c'~A+�'' ' �. k. c'", s <��r..��,
�, CITY STATE�ZIP�" .���,`lt,,• FAX ° +>; r� '; ' '
�,
CONTRACTOR S LICENSE# � f �' '�= � EXP DATE CITY LICENSE# c?�' �- •�� y�"'--ti
,_r�
PLUMBING CONTRACTOR �y;� TELEPHONE��t',-�A"� °` � --'�
ADDRESS EMAIL
�
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE_CITY LICENSE#
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP FAX
CONTRACTOR'S LICENSE# EXP DATE_CITY LICENSE#
Copy of City Mitigation documentation(TFC).
� I hereby certify that the above information is correct and that the construction on,and the occupancy and the use of the
above described property will be in accordanFe,�with the laws,rules and regulations of the State of Washington and the
City of Yelm. �
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Applicant'.s Signature Date
Owner/Contractor/Owner's Agent/Contractor's Agent/Tenant (Please circle one.)
All permits are non-transferable and will expire if work authorized by such permit is not begun
within 180 days of issuance, or if work is suspended or abandoned for a period of 180 days
�C���T��
� JIJN 0� 2013
105 Yelm Avenue West ( 8-3835
PO Box 479 �
Yelm, WA 98597 www.ci.yelm.wa.us
�
o� �.► City of Yelm Permit No.: 20130266
� Community Development Department Issue Date: 7I30/2013
� (Work must be completed within 180 days)
Building Division
Phone: (360)458-8407
""" » _°" Fax: (360)458-3144
Applicant:
Name: STACY CRAIN Phone:
Address: 8270 28TH CT NE
LACEY WA 98516
Property Information:
site Address: 1201 YELM AVE E 100B Owner: STACY CRAIN
Assessor Parcel No.: 22730110403 Subdivision: Lot:
Contractor Information:
Name: STACY CRAIN Phone:
Address:
8270 28TH CT NE
LACEY WA 98516
Contractor License No.: Expires: 0/00/0000
Project Information:
Project: COMMERCIAL REMODEL
Description of Work: LIMEBERRY TI, B OCCUPANCY WITH 15 OR LESS
Sq. Ft. per floor: First Heat Type(Electric, Gas, Other):
Second
Third
Garage
Basement
Fees:
Item Contractor Fees
BUILDING BAILEY GENERAL CONTRACTOR $ 576.26
PLUMBING STACY CRAIN $ 62.00
�
TOTAL FEES: 5 638.26
Applicant's Affidavit: OFFICIAL USE ONLY
I certify that I have read and examined the information contained within the application and know the same
to be true and correct. I also certify that the proposed structure is in confortnity with all applicable City of #Sets of Prints:
Yelm regulations inclu ing those governing zoning and land subdivision,and in addition,all covenants,
easements and restri cord. If applying as a contrador,I further certify that I a curr ntly Final Inspection:
registered in the Stat hi ton.
Signature Date
� �� f� o�:
By:
Firm
CITY OF YELM
COMMERCIAL BUILDING PERMIT APPLICATION FORM
Project Address:_ � �1, ���ti.. �v� �. �,•�(.���Parcel#:
Zoning; Current Use: ° Proposed Use: ���+�^y
❑ New Construction Re-Model/Re-Roof/Tenant Improvement
� Plumbing ❑ Mechani I ❑ Fire Prevent/Suppress/Alarm ❑ Other
Project DescriptioNScope of Work:_ �1 �� � ,0,.�`70�,� ��n������
Project Value: � ��?
Building Area (sq. ft) Parking Garage 1�` Floor (�j[}L 2"d Floor 3�d Floor
Building Height
Are there any environmentally sensitive areas located on the parcel? If es, a
completed environmental checklist must accom an y
p y permit application.
BUILDING OWNER/TEPIANT NAME:
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
ARCHITECT/ENGINEER LICENSE#
ADDRESS EMAIL
CITY STATE ZIP TELEPHONE
GENERALCONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE Z�p FAX
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
PLUMBING CONTRACTOR � TELEPHONE_ 3 G f7� ?�i 1 — 2
ADDRESS � Z(p
CITY DI+�y�� STATE_ 'W Z�p_ �F�IL
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
MECHANICAL CONTRACTOR TELEPHONE
ADDRESS EMAIL
CITY STATE ZIP F,qX
CONTRACTOR'S LICENSE# EXP DATE CITY LICENSE#
Copy of City Mitigation documentation(TFC).
I hereby certify that the above information is correct and that the construction on,and the occupancy and the use of the
above described property wi11 be in accordance with the laws,rules and regulations of the State of Washington and the
City of Ye ,
� '
Applican s ignature � S I �
Owner/Contractor/Owner's Agent/Contractor's Agent/Tenant (Please circle one.)
All permits are non-transferable and will expire if work authorized by such permit is not begun
within 180 days of issuance, or if work is suspended or abandoned for a period of 180 days
105 Yelm Aue W (360)458-3835
Yelm, WA 98597 (360)458-3744 FAX
www.ci.yelm.wa,us
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